Leaked papers reveal N&N hospital chiefs halt “crucial” plans for new day facility and children’s A&E

Norfolk and Norwich University Hospital. Date: Aug 2014. Picture: MIKE PAGE

Norfolk and Norwich University Hospital. Date: Aug 2014. Picture: MIKE PAGE

Copypright Mike Page, All Rights Reserved Before any use is made of this picture, including dispaly, publication, broadcast, syn

Plans for a “crucial” expansion at Norfolk’s biggest hospital have been halted because of crippling finances, this newspaper can reveal.


The finances at Norfolk and Norwich University Hospital NHS Foundation Trust have taken a nosedive in the last five years.

The N&N trust, which also runs Cromer Hospital, posted a healthy surplus of around £6m in 2012/13.

But a rise in demand and the need to make savings has put huge pressure on the N&N’s bank accounts.

The following year it posted a surplus of £5m, but in 2014/15 it recorded a deficit for the first time (around £9m).

Last year the N&N slipped into a £21m deficit and this financial year it is set to fall further into the red (£32m).

Ex-chief executive Anna Dugdale resigned last summer and was replaced by Mark Davies, who has been in post for just over a year.

Early on in his tenure he outlined the need for larger facilities to meet future demand.

But in spring his vision was already threatened after the N&N faced fines of up to £10m by commissioners after missing A&E, cancer, and other treatment targets.

Earlier this year Mark Davies, chief executive of Norfolk and Norwich University Hospital (N&N), announced plans for a brand new day-case and diagnostics centre – and expanding the emergency department – which were essential to the N&N’s future.

But a leaked email to this newspaper shows Mr Davies has been forced to place these plans on hold because of the serious financial position the N&N finds itself in.

The hospital, which was placed in financial special measures in July, faces a £32m deficit by March next year and must deliver more than £20m in savings.

This means patients may have to wait longer for non-emergency treatment or even travel further away to be seen by doctors.

A spokesman for staff union Unison said staff would be disappointed by the decisions.

It comes a month after 68 beds were closed across three wards for two months in a bid to drive down spending on temporary nurses.

Five years ago the N&N trust carried out 63,000 day-case surgery procedures annually, compared with 92,000 now – and the trust predicts that number to rise to 120,000 in the next seven years.

That is why the new day-case and diagnostics centre was described as crucial by Mr Davies.

It was hoped the new centre would free up space for an expansion of the hospital’s A&E and children’s A&E. The latter was criticised by health watchdog the Care Quality Commission in its March report this year.

But in his email, written to staff, Mr Davies hinted that it may not make sense to build the centre pending a “rebalancing of services across Norfolk” under the region’s “Sustainability and Transformation Plan” – which is being drawn up by health chiefs.

Mr Davies also indicated that the hospital may move away from spending money on hitting the 18-week patient non-emergency treatment target – a key target that has been missed every month since September 2014. This is because the hospital needs to focus on its A&E and cancer treatment performance, he wrote.

A spokesman for the N&N said they hope the plans can be resumed once NHS Improvement lifts the financial special measures.

However it is not known when this could happen.

‘Staff will be disappointed’ - Unison

Harry Seddon, a member of union Unison at the N&N, said that staff would be disappointed at the decision – but added he suspected few members had much time to think about the future given the pressures they face today.

Mr Seddon said the plans to increase capacity had put a bit of light at the end of the tunnel, but “now that seems to have gone out again”.

“Our local management appeared to have accepted that the pressure on existing space, beds, and staff is currently intolerable, and had plans to increase capacity,” he said.

“But the government is keen to ‘postpone’ capital programmes like these largely because by kicking the expenditure into the future they can make this year’s NHS deficits look better than they really are. “Whether NHS deficits should be viewed as overspending or underfunding depends on your political view. But politicians can’t keep ducking the issue of NHS demand and adequate funding for much longer.

“So these decisions are a real disappointment, but people should be worrying about the bigger NHS picture right now.”

Hospital trust explains decision

The cost of planning, engineering, architectural advice, and transport issues are among reasons why the N&N has placed plans for its new day-case centre on hold.

According to a three-year financial plan in the hospital’s most recent board papers, the cost of the new day-case and diagnostics centre and children’s A&E expansion would be around £45m.

A spokesman for the hospital said a project on this scale involved several hundreds of thousands of pounds expenditure with external advisors to ensure the scheme is successful.

“The projects remain viable schemes. But the hospital trust must curb discretionary expenditure and this included further expenditure on developing these schemes,” the spokesman said.

“It is important to be clear that we will protect front-line emergency services at all times.

“However we will continue to scrutinise other areas of expenditure including management, back office and the use of temporary staff.”

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